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- W2389099034 abstract "Background: Recent trials suggest patients with diabetes may do better with coronary-artery bypass graft (CABG); however long-term trends in the rates of CABG and percutaneous coronary intervention (PCI) compared to medical therapy from a real-world population are not well known. Methods: We analyzed 1003 DM patients admitted with acute coronary syndrome (ACS) from 1999 to 2008 at a tertiary care center. Rates of revascularization were examined by study year. In addition in-hospital, 6mo and 2yr outcomes were obtained by phone interview and medical chart review. Multiple logistic regression models were created for 6mo and 2yr outcomes, adjusting for variables known to be associated with mortality. Results: Of 1003 DM/ACS patients, 505 were medically managed, 399 received percutaneous coronary intervention (PCI) and 99 received a coronary-artery bypass graft (CABG). At baseline, the medical group was the oldest and sickest. Rates of CABG increased particularly in the years between 2001 and 2003, and rates of PCI increased from 2003 to 2006. Both types of revascularization procedures have declined in recent years and medical management accounts for over 50% of diabetic ACS patients. (Figure 1) At 6mo, both CABG (p=0.02, OR 0.17, 95%CI 0.04-0.74) and PCI (p=0.03, OR 0.46, 95%CI 0.23-0.92) reduced mortality among DM patients after controlling for the GRACE risk score. A similar reduction in mortality was noted at 2yr for CABG (p=0.01, OR 0.35, 95%CI 0.16-0.77) and PCI (p=0.03, OR 0.62, 95%CI 0.40-0.95) compared to medical therapy alone. Conclusions: Rates of revascularization among DM/ACS patients have declined in recent years, particularly for CABG. Both types of revascularization are associated with significant survival benefit, suggesting improving access to these procedures among DM/ACS patients is warranted." @default.
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- W2389099034 date "2012-04-01" @default.
- W2389099034 modified "2023-10-18" @default.
- W2389099034 title "Abstract 48: Diabetic Patients with Acute Coronary Syndrome Have Better 6 Month and 2 Year Outcomes with Revascularization Compared to Medical Therapy Alone" @default.
- W2389099034 doi "https://doi.org/10.1161/circoutcomes.5.suppl_1.a48" @default.
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